| NPI | 1386453413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MO VALERIE PAYLEN Licsw 612-239-7612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-01-03 |
| Last Update Date | 2025-01-03 |